Risk stratification by guidelines compared to tisk assessment by risk equations applied to a MONICA sample

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Persson, Mats,1954-Umeå universitet,Allmänmedicin (author)

Risk stratification by guidelines compared to tisk assessment by risk equations applied to a MONICA sample

Article/chapterEnglish2003

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Lippincott Williams & Wilkins,2003
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LIBRIS-ID:oai:DiVA.org:umu-96548
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96548URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Background: The World Health Organization/International Society of Hypertension (WHO/ISH) Hypertension Guidelines from 1999 propose a risk stratification scheme for estimating absolute risk for cardiovascular disease (CVD). Risk equations estimated by statistical methods are another way of predicting cardiovascular risk. Objective: We studied the differences between these two approaches when applied to the same set of individuals with high blood pressure. Design and methods: The two northernmost counties in Sweden (NSW) constitute one of the centres in the WHO MONICA (monitoring trends and determinants in cardiovascular disease) Project. Three population surveys have been carried out in 1986, 1990 and 1994, and were used to estimate a risk equation for predicting the 10-year risk of fatal/non-fatal stroke and myocardial infarction. Another MONICA sample from 1999, a total of 5997 subjects, was classified according to the recent WHO/ISH risk stratification scheme. A risk assessment was also performed, by using the risk equations from the NSW MONICA sample and Framingham risk equations. Results: The agreement between the two methods was good when the values obtained from the risk equation were averaged for each risk group obtained from the risk classification by guidelines. However, if the predicted risk for each individual was considered, the agreement was poor for the medium and high-risk groups. Although the average risk for all individuals is the same, many subjects have a higher risk or a lower risk than predicted by guidelines. Conclusions: Risk classification by the 1999 WHO/ISH Hypertension Guidelines is not accurate and detailed enough for medium- and high-risk patients, which could be of clinical importance in the medium risk group.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
NATURVETENSKAP Matematik Sannolikhetsteori och statistik hsv//swe
NATURAL SCIENCES Mathematics Probability Theory and Statistics hsv//eng
NATURVETENSKAP Matematik Annan matematik hsv//swe
NATURAL SCIENCES Mathematics Other Mathematics hsv//eng
Hypertension Guidelines
hypertension
risk equation
risk stratification
absolute risk

Added entries (persons, corporate bodies, meetings, titles ...)

Carlberg, Bo,1952-Umeå universitet,Medicin(Swepub:umu)boca0001 (author)
Weinehall, Lars,1948-Umeå universitet,Epidemiologi och global hälsa(Swepub:umu)lawe0001 (author)
Nilsson, LeifUmeå universitet,Institutionen för matematik och matematisk statistik(Swepub:umu)leni0003 (author)
Stegmayr, Birgitta,1947-Umeå universitet,Medicin(Swepub:umu)bist0001 (author)
Lindholm, Lars HjalmarUmeå universitet,Allmänmedicin(Swepub:umu)lali0003 (author)
Umeå universitetAllmänmedicin (creator_code:org_t)

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In:Journal of Hypertension: Lippincott Williams & Wilkins21:6, s. 1089-10950263-63521473-5598

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and General Practice

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